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Distributed for UCL Press

Petty Tyranny and Soulless Discipline?

Patients, Policy and Practice in Public Mental Hospitals in England, 1918–1930

Distributed for UCL Press

Petty Tyranny and Soulless Discipline?

Patients, Policy and Practice in Public Mental Hospitals in England, 1918–1930

The first dedicated book on public mental hospital services in England in the decade following World War I.

Petty Tyranny and Soulless Discipline? examines England’s public mental hospitals for the working class after World War I. Claire Hilton combines narratives of patients’ difficult daily lives with an analysis of competing agendas from campaigners, the government, and new medical knowledge to build a complex picture of mental health provision. Patient experiences, including their admission, care, treatment, discharge, and sometimes death, are illuminated in previously unexplored primary sources and situated within the broader context of reform and change (or lack thereof). While offering a comprehensive history of psychiatric care in early twentieth-century England, the book also draws on historical insights to reflect on contemporary mental health practices, making it relevant to historians, mental health professionals, and patients alike.

292 pages | 6.14 x 9.21 | © 2025

History: British and Irish History

History of Science


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Reviews

"Dr Hilton's comparison of psychiatric care in the 1920s and the 2020s is, by turns, elegant, stunning, salutary and chilling. Throughout, she reminds us of the dangers of what Rob Behrens has dubbed "bunker-ism". This excellent book is the beginning of an antidote, if not cure, for this common affliction."

Nicol Ferrier, Newcastle University

"A groundbreaking and sobering read, which has seismic implications for the field of mental health care in the future. It should be compulsory reading for clinicians and providers of mental health services."
 

Jane Warner, Plymouth University

Table of Contents

List of figures
List of tables
List of abbreviations
Preface
Foreword
Acknowledgements

1 Introduction: historical context and methodological considerations
2 Outside to inside: public experience and understanding, and into the mental hospital
3 Certified under the Lunacy Act: patients’ daily life in hospital, and after
4 Challenges for the mental hospital doctors: medical knowledge and treating patients
5 Regulatory culture: structure and staff
6 Reform
7 Epilogue: reflections then and now

References
Index

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